{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T06:25:22Z","timestamp":1780727122462,"version":"3.54.1"},"reference-count":21,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2018,10,2]],"date-time":"2018-10-02T00:00:00Z","timestamp":1538438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2018,10,2]],"date-time":"2018-10-02T00:00:00Z","timestamp":1538438400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neonatology"],"published-print":{"date-parts":[[2019]]},"abstract":"<b><i>Introduction:<\/i><\/b> Bubble continuous positive airway pressure (bCPAP) generates a variable pressure due to bubble size and frequency, and these pressure oscillations may contribute to lung recruitment and gas exchange. Single-outlet bCPAP devices generate larger pressure fluctuation than bCPAP devices with diffusers, but clinical efficacy is unclear. Our hypothesis was that a single-outlet bCPAP device (B&amp;B Bubbler<sup>\u00a9<\/sup>) would decrease extubation failure and improve oxygenation compared with a bCPAP device with a diffuser (BabiPlus<sup>\u00a9<\/sup>). <b><i>Methods:<\/i><\/b> Bench testing of bCPAP devices with the RAM<sup>\u00a9<\/sup> cannula determined pressure averages, fluctuations, and CPAP transmission at prongs. The B&amp;B Bubbler<sup>\u00a9<\/sup> and the BabiPlus<sup>\u00a9<\/sup> devices were compared for oxygenation and bCPAP failure within 72 h of extubation in a randomized trial in infants less than 1,250 g (<i>n<\/i> = 43). Additionally, a cohort study with infants extubated to BabiPlus<sup>\u00a9<\/sup> (<i>n<\/i> = 128), B&amp;B Bubbler<sup>\u00a9<\/sup> (<i>n<\/i> = 119), and noninvasive positive pressure ventilation (NIPPV) (<i>n<\/i> = 107) were compared. <b><i>Results:<\/i><\/b> Small differences in pressure fluctuations between bCPAP devices are attenuated by the RAM<sup>\u00a9<\/sup> cannula. Pressures at RAM<sup>\u00a9<\/sup> prongs are 62% of set pressure. The bCPAP extubation failure rate (35%) and oxygenation were similar between the bCPAP devices. bCPAP success was associated with lower FiO<sub>2<\/sub> at extubation and decreased need for additional FiO<sub>2<\/sub> in both groups. In the setting of the RAM<sup>\u00a9<\/sup> cannula, there were no differences in extubation failure rate for infants extubated to bCPAP or NIPPV. <b><i>Conclusions:<\/i><\/b> There were no clinical differences at extubation between the B&amp;B Bubbler<sup>\u00a9<\/sup> and BabiPlus<sup>\u00a9<\/sup> devices. Oxygenation may predict bCPAP failure. The use of the RAM<sup>\u00a9<\/sup> cannula as a bCPAP interface should be more closely examined.<\/jats:p>","DOI":"10.1159\/000493156","type":"journal-article","created":{"date-parts":[[2018,10,2]],"date-time":"2018-10-02T21:01:27Z","timestamp":1538514087000},"page":"28-35","source":"Crossref","is-referenced-by-count":23,"title":["Comparison of Bubble CPAP Devices Using RAM Cannula for Extubation Failure in Very Low Birth Weight Infants: Randomized and Cohort Studies"],"prefix":"10.1159","volume":"115","author":[{"given":"Colleen\u00a0C.","family":"Claassen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah\u00a0H.","family":"Hillman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard\u00a0L.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marya\u00a0L.","family":"Strand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2018,10,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197106172842401"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2016.02.009"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.03432"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1080\/03091900601164838"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200609-1368OC"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201101-0055OC"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f5980"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2016.02.008"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2005.04.062"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedneo.2012.08.013"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1203\/PDR.0b013e3181f985f0"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2004.062588"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1203\/PDR.0b013e318123f702"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23197"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.04251"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.03560"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-017-2851-x"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0193807"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2008.12.034"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1300071"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201101-0055OC"}],"container-title":["Neonatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/493156","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/493156","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T16:48:46Z","timestamp":1745426926000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000493156"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,2]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,1,9]]},"published-print":{"date-parts":[[2019,1,15]]}},"URL":"https:\/\/doi.org\/10.1159\/000493156","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.7156433","asserted-by":"subject"}]},"ISSN":["1661-7800","1661-7819"],"issn-type":[{"value":"1661-7800","type":"print"},{"value":"1661-7819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,2]]}}}